Cognitive assessment during inpatient rehabilitation after spinal cord injury, a retrospective cross-sectional study

Study design

Cross-sectional study.

Objectives

Cognitive screening is underdeveloped in spinal cord injury (SCI). Therefore, the objectives of our study were: (1) to evaluate cognitive functioning of rehabilitation inpatients with recently acquired spinal cord injury (SCI) with the Montreal Cognitive Assessment (MoCA); (2) to analyse associations between patient and lesion characteristics and the MoCA scores and (3) to compare the MoCA with the cognitive domain of the Utrecht scale for Evaluation of Rehabilitation (USER).

Setting

Inpatient rehabilitation in a specialized rehabilitation centre in the Netherlands.

Methods

MOCA and USER data of inpatients between November 2020 and December 2021 were used. Correlation and regression analysis were used.

Results

Included were 98 adults aged (median) 61.6 years (range 19.5–83.6), 66% male, 26.5% traumatic SCI, 63% persons with paraplegia. MoCA and USER scores were available for 83 and 92 individuals, respectively. In 44.6% of the participants, the MoCA score was below the cut-off. Age (r = 0.31, p = 0.005) and educational level (r = 0.54 P < 0.00) were significantly correlated to the MoCA score. The MoCA and the cognitive domain of the USER were moderately correlated (r = 0.25, p = 0.03).

Conclusions

Almost half of the inpatients scored below the cut-off score on the MoCA. Since the MoCA is a validated cognitive screening tool, the moderate correlation of the MoCA and the cognitive domain of the USER suggests that the USER alone is not sufficient in detecting cognitive deficits. We recommend to screen for cognitive deficits in all people with new SCI.

Sponsorship

None.